Physician Compare National (NPI:1578731212)

HEALTHCARE PROVIDER: MOHAMMAD ALMUBASLAT M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1578731212
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052437498
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120515000506
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ALMUBASLAT
	Individual professional last name
Provider First Name	MOHAMMAD
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	NEUROSURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	100 MARINERS BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1
	Group Practice or individual's line 2 address
City	MANDEVILLE
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	704486811
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	190045
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST TAMMANY PARISH HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y